WPC  )L,TЍЍ~9W鐹'k e^M{Nrv]f˿֌l9W=jgH(i[Gh/xbz!|CJ6hib<{(l_W;%rILNk PZj=w{Z$ a.*[ꬸidA^۾tE*IћVLvl:~E!XIWb$}$}WG|K虶#F{bႄ"=&8+A¤<VHC p (%YNx剾qR@>R8TqG~Nfh P ?PWrɩNg%0#< ܭ)ڍdk<;V;AP7tA>BFgӛ P&}}Cڅ\ȱ(_ [1D67YٯBU *B 0U>U2UJH 0#XUN! %o Mu (y N ^ w 4  m %2A`Arial' FILLING OUT THE LEAD PAINT DISCLOSURE FORM Dan Adair0Dan Adair .   <lX:Default ParaS\  `&Times New RomanS?%2A`Arial?\  `&Times New Roman $Tw Cen MT2L@ 1`2PopplLaudatio-Regular#|x(($XX..       :X X :HP DeskJet 840C/841C/842C/843C0X,,,,0X0(9 Z6Times New Roman Regular X[4 Pb3:i+00U (!XX..       %X Xa %  _       XX  da FILLINGOUTTHELEADPAINTDISCLOSUREFORM X   XXdIfyouarerentingaresidencethatwasbuiltpriorto1978,youarerequiredbyFederalLawto p givethetenantaLeadPaintDisclosureformatthepointthattheyrentthepremises.Tofill V outyourleadpaintdisclosureform,printoutthisdocumentandsetitasideforreference. < Thenopenthedocumentcalled,_"lead.wpd."_ԀIfyou'refillingitoutwithapen,justprintitout; " ifyou'reusingyourwordprocessor,thenkeepitopen.Followthesimplenumberedstepsin  theexamplebelow.  1Thelandlordshouldinitialtheformhere.  b  2Ifthereareknownleadpainthazardsinthehome,youshouldputacheckmarkorXhere.  .  3Onthisline,youfillinwhattheknownhazardsare.Ifyou'reusingyourwordprocessor, R  thenjustbackspaceoverthelineandfillinthehazards. 8  4IfthelandlordisNOTawareofanyknownleadpainthazardsinthehome,thenputacheck  markorXhere.  5Ifthelandlordhasanyrecordsorreportsaboutleadhazardsintheresidence,putacheck ^ orXhere.(Thesemightbesuchthingsashousinginspector'sreports,_buiding_Ԁinspector D citations,etc.) * 6Ontheselines,youindicatewhatthereportsorrecordsare. N 7Ifyouhavenoreportsorrecords,thenyouwouldputacheckmarkoranXhere.  8Hereyouhaveachoicebetweentwostatements.Federallawrequiresthatanytenantbe  givenatendaygraceperiodtohaveaninspectionforleadhazardsdone.Ifthetenantwants t todothat,youputacheckmarkoranXinfrontofthefirstsentence.Ifthetenantdecidesto Z waivehavinganinspectiondone,thenyouputacheckmarkoranXinfrontofthesecond @ sentence. ~& 9Iftheresidenceisbeingrentedoutbyarealestateagent,ratherthantheactualowner,the J ! agentshouldputhis/herinitialshere. 0!" 10Ifthereisanagent,thenhe/sheshouldputanXoracheckmarkhere,indicatingthatthe " $ landlordwasinformed. #!% Finally,printouttwocopies.Allpartiesshouldsignitandeachpartyretainonecopy. %V#'   dXXLEADBASEDPAINTAND/ORLEADBASEDPAINTHAZARDSDISCLOSURE F)&+   XXdLeadWarningStatement ^+)-  Everytenantofanyinterestinresidentialrealpropertyonwhicharesidentialdwellingwasbuiltprior D,). to1978isnotifiedthatsuchpropertymaypresentexposuretoleadfromleadbasedpaintthatmay *-*/ placeyoungchildrenatriskofdevelopingleadpoisoning.Leadpoisoninginyoungchildrenmay .+0 producepermanentneurologicaldamage,includinglearningdisabilities,reducedintelligencequotient, .,1 behavioralproblems,andimpairedmemory.Leadpoisoningalsoposesaparticularrisktopregnant /-2 women.Thelandlordofanyinterestinresidentialrealpropertyisrequiredtoprovidethetenantwith X anyinformationonleadbasedpainthazardsfromriskassessmentsorinspectionsinthelandlords > possessionandnotifythetenantofanyknownleadbasedpainthazards.Ariskassessmentor $ inspectionforpossibleleadbasedpainthazardsisrecommendedbeforetakingoccupancy.    LandlordsDisclosure (Landlordmustinitialhere:򀀀 1 󀀀 ) ~ (a)Presenceofleadbasedpaintand/orleadbasedpainthazards(check(1)or(2)below): J (1)򀀀 2_ known_Ԁleadbasedpaintand/orleadbasedpainthazardsarepresentinthehousing  0 (explain). n   _____________________________________ 3 __________________________________________ T   (2)򀀀 4 󀀀Landlordhasnoknowledgeofleadbasedpaintand/orleadbasedpainthazardsin :  thehousing.   (b)Recordsandreportsavailabletothetenant(check(1)or(2)below):   (1)___ 5 ___Landlordhasprovidedthetenantwithallavailablerecordsandreportspertainingtolead   basedpaintand/orleadbasedpainthazardsinthehousing(listdocumentsbelow). z  ______________________________________ 6 __________________________________________ ` ________________________________________________________________________________ , (2)___ 7 ___Landlordhasnoreportsorrecordspertainingtoleadbasedpaintand/orleadbasedpaint P hazardsinthehousing. 6  TenantsAcknowledgment ......ProtectYourFamilyfromLeadinYourHome.  (e)Tenanthas(check(1)or(2)below):  (1)___ 8 ___receiveda10dayopportunity(ormutuallyagreeduponperiod)toconductarisk v assessmentorinspectionforthepresenceofleadbasedpaintand/orleadbasedpainthazards. \ (2)__ 8 ____waivedtheopportunitytoconductariskassessmentorinspectionforthepresenceof B leadbasedpaintand/orleadbasedpainthazards. (  AgentsAcknowledgment (Agentmustinitialhere:____ 9 _____) L (f)򀀀 10 󀀀_Agent_Ԁhasinformedthelandlordofthelandlordsobligationsunderfederallawandis 2 awareofhis/herresponsibilitytoensurecompliance.   _____________________________________________________________________  "   X XXXLandlord `  Date   h     Tenant p     Date !r# _____________________________________________________________________________ ~#&!%   Tenant   `  Date   h     Tenant p     Date X$"& _____________________________________________________________________________  &#(   Tenant   `  Date   h     Agent p     Date &$)   XX=p  X/ X =pXX XX/    aXX